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Prediction of the development of organ failures in patients with systemic inflammatory response syndrome by determination of plasma levels of soluble E-selectin

Aim

Plasma levels of soluble E-selectin (SE) were shown to be increased in patients with septic shock as a consequence of the endothelial cell activation by tumor necrosis factor-alpha (TNF-α). Excessive production of TNF-α induces systemic inflammatory response syndrome (SIRS), which might frequently lead to the development of organ failure by activating neutrophils. The present study was undertaken to examine whether determination of plasma levels of SE might predict the development of organ failures in patients with SIRS.

Methods

Subjects in the present study were 39 patients with SIRS admitted to the emergency unit. Plasma levels of SE were determined by ELISA at admission and 1, 3, 5, and 7 days after the admission. The normal range of SE was 3.17–32.09 ng/ml. The presence of various organ failures was diagnosed when patients had the SOFA score higher than 3 points in each organ dysfunction scoring system. A two-sided Fisher's exact test was used to analyze the difference in the incidence of organ failure and the mortality. P < 0.05 indicated the statistical significance.

Results and discussion

SOFA scores in the first 8 days in the emergency unit were significantly higher in patients with elevated SE levels at admission (DAE group, n = 15) than those with normal SE levels at admission (DAN group, n = 24). The incidence of respiratory failure in that period was significantly higher in the DAE group (73.3%) than in the DAN group (16.7%) (P < 0.01), and that of renal failure was also significantly higher in the DAE group (33.3%) than in the DAN group (0%)(P < 0.01). The mortality at 28 days after admission in the DAE group (20.0%) was significantly higher than that in th eDAN group (0%) (P < 0.05). These observations suggested that determination of plasma levels of SE might be useful for prediction of the development of organ failures, especially that of respiratory and renal failure, and the outcome of such patients with SIRS might have the potential risk for development of multiorgan failure.

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Okajima, K., Koga, M., Suga, H. et al. Prediction of the development of organ failures in patients with systemic inflammatory response syndrome by determination of plasma levels of soluble E-selectin. Crit Care 8, P192 (2004). https://doi.org/10.1186/cc2659

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Keywords

  • Renal Failure
  • Plasma Level
  • Septic Shock
  • Respiratory Failure
  • Organ Failure